主页 > 医药科学 >
【文摘发布】急性心肌梗死患者肾上腺髓质中间
Sohail Q. Khan, BSC (HONS), MBCHB, MRCP,* Russell J. O’Brien, MBCHB, MRCP,* Joachim Struck, PHD,† Paulene Quinn, MPHIL,* Nils Morgenthaler, PHD,† Iain Squire, MD, FRCP,* Joan Davies, PHD, FRCP,* Andreas Bergmann, PHD,† Leong L. Ng, MD, FRCP* Leicester, United Kingdom; and Hennigsdorf, Germany
Objectives This study sought to assess the prognostic impact of midregional pro-adrenomedullin (MR-proADM) after an acute myocardial infarction (AMI).
Background Adrenomedullin (ADM) is elevated in heart failure (HF) and after AMI. Another part of its precursor, MR-proADM, is more stable in circulation and ex vivo. We investigated the cardiovascular prognostic value after AMI of MRproADM and compared it with N-terminal pro-B-type natriuretic peptide (NTproBNP), a marker of death and HF.
Methods We measured plasma MR-proADM and NTproBNP in 983 consecutive post-AMI patients (721 men, mean age 65.0±12.2 years), 3 to 5 days after chest pain onset.
Results There were 101 deaths and 49 readmissions with HF during follow-up (median 342, range 0 to 764 days). The MR-proADM was increased in patients with death or HF compared with survivors (median 1.19 nmol/l, range 0.09 to 5.39 nmol/l, vs. 0.71 nmol/l, range 0.25 to 6.66 nmol/l, p<0.0001). Using a multivariate binary logistic model, log MR-proADM (odds ratio 4.22) and log NTproBNP (odds ratio 3.20) were significant independent predictors of death or HF (with creatinine, age, gender, and history of AMI). The areas under the receiveroperating characteristic curve for MR-proADM, NTproBNP, and the logistic model with both markers were 0.77, 0.79, and 0.84 respectively. Cox models for the predictors of death or HF showed the same variables (including log MR-proADM, hazard ratio 3.63; log NTproBNP, hazard ratio 2.67). The MR-proADM provided further risk stratification in those patients who had NTproBNP levels above the median (p<0.0001). Findings were similar for death and HF as individual end points.
Conclusions The ADM system is activated after AMI. The MR-proADM is a powerful predictor of adverse outcome, especially in those with an elevated NTproBNP. The MR-proADM may represent a clinically useful marker of prognosis after AMI.
(J Am Coll Cardiol 2007;49:1525–32) © 2007 by the American College of Cardiology Foundation
IF：9.200 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 Prognostic Value of Midregional Pro-Adrenomedullin in Patients With Acute Myocardial Infarction
肾上腺髓质素前体中间肽段对于急性心肌梗死患者的预后价值
Sohail Q. Khan, BSC (HONS), MBCHB, MRCP,* Russell J. O’Brien, MBCHB, MRCP,* Joachim Struck, PHD,† Paulene Quinn, MPHIL,* Nils Morgenthaler, PHD,† Iain Squire, MD, FRCP,* Joan Davies, PHD, FRCP,* Andreas Bergmann, PHD,† Leong L. Ng, MD, FRCP* Leicester, United Kingdom; and Hennigsdorf, Germany
作者：Sohail Q. Khan, BSC (HONS), MBCHB, MRCP,* Russell J. O’Brien, MBCHB, MRCP,* Joachim Struck, PHD,† Paulene Quinn, MPHIL,* Nils Morgenthaler, PHD,† Iain Squire, MD, FRCP,* Joan Davies, PHD, FRCP,* Andreas Bergmann, PHD,† Leong L. Ng, MD, FRCP* Leicester, 英国; and Hennigsdorf, 德国
Objectives This study sought to assess the prognostic impact of midregional pro-adrenomedullin (MR-proADM) after an acute myocardial infarction (AMI).
目的：这项研究旨在探寻肾上腺髓质前体中间肽段（MR-proADM）对于急性心肌梗死的预后的影响。
Background Adrenomedullin (ADM) is elevated in heart failure (HF) and after AMI. Another part of its precursor, MR-proADM, is more stable in circulation and ex vivo. We investigated the cardiovascular prognostic value after AMI of MRproADM and compared it with N-terminal pro-B-type natriuretic peptide (NTproBNP), a marker of death and HF.
背景：肾上腺髓质素（ADM）水平在心力衰竭（HF）和急性心肌梗死（AMI）后升高。肾上腺髓质前体中间肽段（MR-proADM）是肾上腺髓质素前体的另一部分，在循环中和体外更稳定。我们研究了MR-proADM对于急性心梗的预后价值，并与另一项死亡和心衰的标记物 N末端-B型利钠肽前体（NTproBNP）对比。
Methods We measured plasma MR-proADM and NTproBNP in 983 consecutive post-AMI patients (721 men, mean age 65.0±12.2 years), 3 to 5 days after chest pain onset.
方法：对983名连续观察的急性心梗后患者（721男，平均年龄65.0±12.2岁），在胸痛发作3-5天，测定血浆MR-proADM和NTproBNP含量。
Results There were 101 deaths and 49 readmissions with HF during follow-up (median 342, range 0 to 764 days). The MR-proADM was increased in patients with death or HF compared with survivors (median 1.19 nmol/l, range 0.09 to 5.39 nmol/l, vs. 0.71 nmol/l, range 0.25 to 6.66 nmol/l, p<0.0001). Using a multivariate binary logistic model, log MR-proADM (odds ratio 4.22) and log NTproBNP (odds ratio 3.20) were significant independent predictors of death or HF (with creatinine, age, gender, and history of AMI). The areas under the receiveroperating characteristic curve for MR-proADM, NTproBNP, and the logistic model with both markers were 0.77, 0.79, and 0.84 respectively. Cox models for the predictors of death or HF showed the same variables (including log MR-proADM, hazard ratio 3.63; log NTproBNP, hazard ratio 2.67). The MR-proADM provided further risk stratification in those patients who had NTproBNP levels above the median (p<0.0001). Findings were similar for death and HF as individual end points.
阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-06 17:11
医学,生命科学网